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General NPI Number Information
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NPI Number | 1013899855
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Entity Type | Organization
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Legal Business Name | RESTORATIVE HOME CARE, LLC
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Dates
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Enumeration Date | 07/23/2025
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 3365 N MONROE ST
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City | TALLAHASSEE
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State | FL
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Zip | 32303-2700
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Country | US
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Telephone | 850-694-2395
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Fax | 850-387-1257
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Provider Business Mailing Address
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Address Line | 3365 N MONROE ST
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City | TALLAHASSEE
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State | FL
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Zip | 32303-2700
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Country | US
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Telephone | 850-694-2395
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Fax | 850-387-1257
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | AMIRACLE GRANT
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Credential |
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Telephone | 850-694-2395
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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